Description

Hey everyone, it’s Dr. Fred Bagares. In this episode, I dive into something I see all the time—patients who recover from an injury, like a lumbar disc herniation, but then get stuck… mentally. Physically, they’re doing great. But emotionally, they’re fearful of moving the wrong way and causing another flare-up.

I walk you through a real case of a surfer who did incredibly well with physical therapy but developed a fear of flexion. We talk about where that fear comes from, why it’s so common, and how we as clinicians—and even friends or family—can support people in getting back to full, confident movement.

🕰 Timestamps & Key Topics:

• [00:36] The case of the cautious surfer
  Young, athletic, diagnosed with a disc herniation—responds well to PT but gets stuck avoiding movement.
• [01:50] Recognizing fear-avoidant behavior
  How I noticed the red flag just by watching the patient get up from a chair.
• [04:07] Today’s focus: managing fear after recovery
  How we help patients transition from protection mode back to full function.
• [05:06] Where does the fear come from?
  Pain, trauma, unknown causes, and imagined worst-case scenarios.
• [06:38] When fear shapes your lifestyle
  How patients may re-engineer their lives to avoid bending—and why that’s a problem.
• [07:55] The MRI effect and mental images of damage
  Why seeing their own scans can sometimes increase fear instead of ease it.
• [09:09] Giving patients tools (not just time)
  Why it’s not enough to say “it’ll get better”—they need options and confidence.
• [11:03] Educating, re-educating, and managing expectations
  How I approach conversations around natural healing timelines and treatment tools.
• [12:27] When imaging can be helpful—for peace of mind
  Why I sometimes order a repeat MRI or EMG even when it’s not medically necessary.
• [13:50] Movement tasks and mental wins
  How I help patients reintroduce movement through safe, scalable activities they enjoy.
• [15:05] Matching the patient to the right care team
  It’s not just about sending them to PT—it’s about finding the right fit.
• [15:59] Getting the surgical perspective (even when it’s not surgical)
  How second opinions can reinforce reassurance.
• [16:24] The patient’s next step: getting back in the water
  Why even dipping back into the pool was a huge milestone for this surfer.

If you’ve ever worked with—or been—the person who’s physically healed but mentally hesitant, this episode is for you. Baby steps matter. Movement matters. And our job is to guide people through both the physical and mental parts of recovery.

🎧 Thanks for tuning in to Talking Rehab Podcast! Don’t forget to subscribe, share, and follow me for more content around sports medicine, spine care, and everything in between.

👉 Connect with me:
Instagram | @drfredbagares
Facebook | @drfredbagares
LinkedIn | Fred Bagares, DO
YouTube | Dr. Fred Bagares
🔗 Linktree

Want me to create a short version for social media captions or YouTube descriptions too?

Support the show